scholarly journals Relative Dose Intensity and Therapeutic Effects of TAS102 for Colorectal Cancer

2021 ◽  
Vol 47 (1) ◽  
pp. 54-59
Author(s):  
Yasunari Okuda ◽  
Makoto Shinada ◽  
Yuki Mikame ◽  
Takahiro Saitoh ◽  
Chihiro Kezuka ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Dose Intensity ◽  
Relative Dose Intensity ◽  
Therapeutic Effects

Charlson Comorbidity Index (CCI) score to predict early reduced relative dose intensity in patients receiving oxaliplatin for colorectal cancer.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e18125-e18125
Author(s):  
Sorcha Ring ◽  
Derbrenn O'Connor ◽  
Niamh Cooney ◽  
Brian Richard Bird
Keyword(s):  
Colorectal Cancer ◽  
Peripheral Neuropathy ◽  
Dose Intensity ◽  
Retrospective Chart Review ◽  
Relative Dose Intensity ◽  
Early Predictors ◽  
Co Morbidity ◽  
Pathology Reports ◽  
Morbidity Index ◽  
Scheduled Time

e18125 Background: Colorectal cancer (CRC) is commonly treated in both adjuvant and palliative settings with Oxaliplatin. Painful peripheral neuropathy resulting in dose adjustments is a well recognized side effect in up to 30% of cases. Relative dose intensity (RDI), an expression of the percentage of planned dose received at a scheduled time, is a tool used to measure how closely a prescription has been adhered to. Studies have suggested a decreased RDI (<85%) is associated with inferior outcomes. The aim of this study was to calculate the RDI for CRC patients undergoing treatment with Oxaliplatin, to investigate reasons for dose delays and reductions and to calculate a Charlson Co-Morbidity Index Score (CCIS) for each patient Methods: CRC patients treated with Oxaliplatin from 2010-2016 within the BSHC were identified using pharmacy lists and pathology reports. The following exclusion criteria were applied: non first line Oxaliplatin and excluding cycles after three months. Data was obtained through a systematic, retrospective chart review. An audit of the chemotherapy prescriptions allowed the RDI to be calculated and the CCIS was calculated using a colorectal specific Index previously described. Results: We identified 176 eligible patients, 83 charts were available for review and 69 charts contained all necessary information to be included. Xelox (61%), Folfox-6 (35%) and Flox (4%) were the chemotherapy agents involved in this study. The average RDI achieved was 87.47%, with a range of 25%-103.17%. The primary cause for dose adjustments was peripheral neuropathy (64%). The CCIS range was 0 -3, with results demonstrating a significant connection between a higher CCI and lower RDI, see table 1. Conclusions: A CCIS ≤ 1 correlates to achieving a higher RDI, with each of these subgroups achieving above the acceptable cut off for RDI (>85%), as such certain co-morbidities may be early predictors of reduced RDI. [Table: see text]

Addition of bevacizumab to compensate for the negative influence of attenuated relative dose intensity of cytotoxic agents on the outcome in patients with metastatic colorectal cancer.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e14614-e14614
Author(s):  
Goro Nakayama ◽  
Naomi Hayashi ◽  
Chie Tanaka ◽  
Tsutomu Fujii ◽  
Yuichi Ando ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Disease Control ◽  
Metastatic Colorectal Cancer ◽  
Standard Dose ◽  
Dose Intensity ◽  
Negative Influence ◽  
Cytotoxic Agents ◽  
Relative Dose Intensity ◽  
Concomitant Therapy ◽  
The Impact

e14614 Background: We reported that relative dose intensity (RDI) of key cytotoxic agents, irinotecan (IRI) and oxaliplatin (OX), is a significant predictor of disease control in patients with metastatic colorectal cancer (mCRC). However, in concomitant therapy with bevacizumab (BEV), the influence of adding BEV on the relation between RDI of cytotoxic agents and outcomes are unclear. In this study, we evaluate the impact of BEV on RDI of IRI and OX-based chemotherapy on the outcome of mCRC. Methods: A retrospective analysis of mCRC patients entered into three prospective clinical trials, testing FOLFIRI (CCOG-0502), mFOLFOX6 (CCOG-0704), FOLFIRI plus BEV and mFOLFOX6 plus BEV (CCOG-0801), was performed. RDI was calculated as the delivered dose intensity divided by standard dose intensity calculated for each regimen and compared to response rate (RR), disease control rate (DCR) and progression-free survival (PFS). Results: In FOLFIRI therapy, higher RDI (IRI, >median: 80%) group achieved significant better RR, DCR and PFS than lower RDI (<median) group (RR: 65 vs. 6% [p=0.001], DCR: 100 vs. 41% [p=0.003] and PFS: 9.9 vs. 5.6 months [p=0.002]). The other hand, in FOLFIRI plus BEV therapy, there were no difference between higher and lower RDI (IRI, median: 76%) group in ORR, DCR and PFS (RR: 31 vs. 27% [p=0.779], DCR: 75 vs. 53% [p=0.208] and PFS: 6.2 vs. 7.3 months [p=0.903]). In mFOLFOX6 therapy, higher RDI (OX, >median: 79%) group achieved better disease control than lower RDI group (RR: 47 vs. 33% [p=0.456], DCR: 100 vs. 73% [p=0.032] and PFS: 8.5 vs. 6.2 months [p=0.064]). In addition of BEV, there were no difference between higher and lower RDI (OX, median: 76%) group in any outcomes (RR: 54 vs. 74% [p=0.159], DCR: 88 vs. 91% [p=0.672] and PFS: 11.6 vs. 11.7 months [p=0.797]). Conclusions: RDI of key cytotoxic agents is a significant predictor of disease control, especially in IRI-based regimen. Nevertheless, in concomitant therapy with BEV, there were no relations between RDI of cytotoxic agents and outcomes. These results suggest that BEV could have ‘covering effect’ to reduce the influence of dose modification of cytotoxic agents in mCRC patients.

Impact of relative dose intensity on the outcome of metastatic colorectal cancer.

2013 ◽  
Vol 31 (4_suppl) ◽  
pp. 508-508 ◽  
Author(s):  
Goro Nakayama ◽  
Takahiro Asada ◽  
Naomi Hayashi ◽  
Chie Tanaka ◽  
Suguru Yamada ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Disease Control ◽  
Metastatic Colorectal Cancer ◽  
Standard Dose ◽  
Objective Response ◽  
Dose Intensity ◽  
Cytotoxic Agents ◽  
Relative Dose Intensity ◽  
Lower Group ◽  
Delivered Dose

508 Background: Relative dose intensity (RDI) is the ratio of delivered dose intensity of chemotherapy to standard dose intensity. There is established evidence supporting the significance of RDI in patients with various cancer, however data in patients with metastatic colorectal cancer (mCRC) are limited. In this study, we evaluate the significance of RDI of irinotecan and oxaliplatin-based chemotherapy on the outcome of mCRC. Methods: A retrospective analysis of mCRC patients entered into two prospective clinical trials, testing FOLFIRI (CCOG-0502) and mFOLFOX6 (CCOG-0704), was performed. RDI was calculated as the delivered dose intensity divided by standard dose intensity calculated for each regimen and compared to objective response rate (ORR), disease control rate (DCR) and progression-free survival (PFS). Results: The median RDI of irinotecan in FOLFIRI and oxaliplatin in mFOLFOX6 were 80% and 79%. ORRs In higher RDI (>median) group and lower RDI (<median) group were 64.7% and 5.9% of irinotecan (p=0.001), and 46.7% and 33.3% of oxaliplatin (p=0.456). DCRs in higher and lower group were 100% and 41.2% in FOLFIRI (p=0.003), and 100 and 73.3% in mFOLFOX6 (p=0.032). PFS in higher and lower group were 9.9 and 5.6 months in FOLFIRI (p=0.002), and 8.5 and 6.2 months in mFOLFOX6 (p=0.064). Conclusions: RDI of key cytotoxic agents is a significant predictor of disease control in patients with mCRC, especially in irinotecan-based regimen. Dose reductions and treatment delays could be minimized to achieve an RDI of at least 80%.

scholarly journals Colorectal Cancer Biomarkers in the Era of Personalized Medicine

2019 ◽  
Vol 9 (1) ◽  
pp. 3 ◽  
Author(s):  
Jai Patel ◽  
Mei Fong ◽  
Megan Jagosky
Keyword(s):  
Colorectal Cancer ◽  
Metastatic Colorectal Cancer ◽  
Therapy Response ◽  
Dose Intensity ◽  
Cancer Biomarkers ◽  
Clinical Implications ◽  
Test Results ◽  
First Line ◽  
Genomic Markers ◽  
Generation Sequencing

The 5-year survival probability for patients with metastatic colorectal cancer has not drastically changed over the last several years, nor has the backbone chemotherapy in first-line disease. Nevertheless, newer targeted therapies and immunotherapies have been approved primarily in the refractory setting, which appears to benefit a small proportion of patients. Until recently, rat sarcoma (RAS) mutations remained the only genomic biomarker to assist with therapy selection in metastatic colorectal cancer. Next generation sequencing has unveiled many more potentially powerful predictive genomic markers of therapy response. Importantly, there are also clinical and physiologic predictive or prognostic biomarkers, such as tumor sidedness. Variations in germline pharmacogenomic biomarkers have demonstrated usefulness in determining response or risk of toxicity, which can be critical in defining dose intensity. This review outlines such biomarkers and summarizes their clinical implications on the treatment of colorectal cancer. It is critical that clinicians understand which biomarkers are clinically validated for use in practice and how to act on such test results.

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